发病率和死亡率
不应忽视老年人的胸壁损伤。老年患者的发病率和死亡率是年轻患者的两倍;骨折肋骨数每增加一根,死亡率增加 19%,肺炎风险增加 27%。[25]Bulger EM, Arneson MA, Mock CN, et al. Rib fractures in the elderly. J Trauma. 2000;48:1040-1047.http://www.ncbi.nlm.nih.gov/pubmed/10866248?tool=bestpractice.com
随着骨折肋骨数的增加,所有年龄组的发病率和死亡率均会明显升高。骨折肋骨数每增加一根,死亡率以及气胸、肺炎和急性呼吸窘迫综合征 (ARDS) 的风险均会显著增加。6 根肋骨骨折是重症并发症的极限点。[25]Bulger EM, Arneson MA, Mock CN, et al. Rib fractures in the elderly. J Trauma. 2000;48:1040-1047.http://www.ncbi.nlm.nih.gov/pubmed/10866248?tool=bestpractice.com[26]Testerman GM. Adverse outcomes in younger rib fracture patients. South Med J. 2006;99:335-339.http://www.ncbi.nlm.nih.gov/pubmed/16634240?tool=bestpractice.com肺炎死亡率较高。[47]Brasel KJ, Guse CE, Layde P, et al. Rib fractures: relationship with pneumonia and mortality. Crit Care Med. 2006;34:1642-1646.http://www.ncbi.nlm.nih.gov/pubmed/16625122?tool=bestpractice.com
疼痛和残疾
单纯肋骨骨折的患者会出现疼痛,但骨折后 4 个月内痛感会逐渐减轻。无论是否伴有合并伤,胸部外伤后离岗养伤的平均时间均约为 70 天。[48]Kerr-Valentic MA, Arthur M, Mullins RJ, et al. Rib fracture pain and disability: can we do better? J Trauma. 2003;54:1058-1064.http://www.ncbi.nlm.nih.gov/pubmed/12813323?tool=bestpractice.com